Individual provider Active NPI

Taylore Chanillo, NP, APRN, FNP-BC, RN

  • Family Nurse Practitioner
  • Bridgewater, NJ
National Provider Identifier
1982352530
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01281300 Issued in NJ
Practice address
1125 Route 22 Ste 155
Bridgewater, NJ 08807-2939
Phone
(908) 947-9863
Fax
(732) 560-3206
NPI assigned
Mar 14, 2022
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01281300 NJ Primary

Addresses

Primary practice location

1125 Route 22 Ste 155
Bridgewater, NJ 08807-2939

Mailing address

1125 Route 22 Ste 155
Bridgewater, NJ 08807-2939
Phone (908) 947-9863

Other identifiers 1

IdentifierTypeStateIssuer
26NR18877800OtherNJRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628001217 NJ Practitioner - Nurse Practitioner 4981062643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

1125 US Hwy 22
Suite 170
Bridgewater, NJ 08807-2939
Phone (908) 947-7011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ01281300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Sep 16, 2024 Accepting new patients
Personal NP Services, LLC CurrentSince Jun 1, 2023 Accepting new patients
Vitality NP Group LLC PastSince Jun 1, 2023 Accepting new patients

Locations

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1982352530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 ROUTE 22 STE 155",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072939",
            "telephone_number": "908-947-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ROUTE 22 STE 155",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072939",
            "telephone_number": "908-947-9863",
            "fax_number": "732-560-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANILLO",
        "first_name": "TAYLORE",
        "credential": "NP, APRN, FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01281300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "26NR18877800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.